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VA Disability Claims: 5 Game-Changing Precedential Decisions You Need to Know
Tbird posted a record in VA Claims and Benefits Information,
These decisions have made a big impact on how VA disability claims are handled, giving veterans more chances to get benefits and clearing up important issues.
Service Connection
Frost v. Shulkin (2017)
This case established that for secondary service connection claims, the primary service-connected disability does not need to be service-connected or diagnosed at the time the secondary condition is incurred 1. This allows veterans to potentially receive secondary service connection for conditions that developed before their primary condition was officially service-connected.
Saunders v. Wilkie (2018)
The Federal Circuit ruled that pain alone, without an accompanying diagnosed condition, can constitute a disability for VA compensation purposes if it results in functional impairment 1. This overturned previous precedent that required an underlying pathology for pain to be considered a disability.
Effective Dates
Martinez v. McDonough (2023)
This case dealt with the denial of an earlier effective date for a total disability rating based on individual unemployability (TDIU) 2. It addressed issues around the validity of appeal withdrawals and the consideration of cognitive impairment in such decisions.
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Tbird, -
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Are all military medical records on file at the VA?
RichardZ posted a topic in How to's on filing a Claim,
I met with a VSO today at my VA Hospital who was very knowledgeable and very helpful. We decided I should submit a few new claims which we did. He told me that he didn't need copies of my military records that showed my sick call notations related to any of the claims. He said that the VA now has entire military medical record on file and would find the record(s) in their own file. It seemed odd to me as my service dates back to 1981 and spans 34 years through my retirement in 2015. It sure seemed to make more sense for me to give him copies of my military medical record pages that document the injuries as I'd already had them with me. He didn't want my copies. Anyone have any information on this. Much thanks in advance.-
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RichardZ, -
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Caluza Triangle defines what is necessary for service connection
Tbird posted a record in VA Claims and Benefits Information,
Caluza Triangle – Caluza vs Brown defined what is necessary for service connection. See COVA– CALUZA V. BROWN–TOTAL RECALL
This has to be MEDICALLY Documented in your records:
Current Diagnosis. (No diagnosis, no Service Connection.)
In-Service Event or Aggravation.
Nexus (link- cause and effect- connection) or Doctor’s Statement close to: “The Veteran’s (current diagnosis) is at least as likely due to x Event in military service”-
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Tbird, -
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Post in ICD Codes and SCT CODES?WHAT THEY MEAN?
Timothy cawthorn posted an answer to a question,
Do the sct codes help or hurt my disability ratingPicked By
yellowrose, -
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Post in Chevron Deference overruled by Supreme Court
broncovet posted a post in a topic,
VA has gotten away with (mis) interpreting their ambigious, , vague regulations, then enforcing them willy nilly never in Veterans favor.
They justify all this to congress by calling themselves a "pro claimant Veteran friendly organization" who grants the benefit of the doubt to Veterans.
This is not true,
Proof:
About 80-90 percent of Veterans are initially denied by VA, pushing us into a massive backlog of appeals, or worse, sending impoverished Veterans "to the homeless streets" because when they cant work, they can not keep their home. I was one of those Veterans who they denied for a bogus reason: "Its been too long since military service". This is bogus because its not one of the criteria for service connection, but simply made up by VA. And, I was a homeless Vet, albeit a short time, mostly due to the kindness of strangers and friends.
Hadit would not be necessary if, indeed, VA gave Veterans the benefit of the doubt, and processed our claims efficiently and paid us promptly. The VA is broken.
A huge percentage (nearly 100 percent) of Veterans who do get 100 percent, do so only after lengthy appeals. I have answered questions for thousands of Veterans, and can only name ONE person who got their benefits correct on the first Regional Office decision. All of the rest of us pretty much had lengthy frustrating appeals, mostly having to appeal multiple multiple times like I did.
I wish I know how VA gets away with lying to congress about how "VA is a claimant friendly system, where the Veteran is given the benefit of the doubt". Then how come so many Veterans are homeless, and how come 22 Veterans take their life each day? Va likes to blame the Veterans, not their system.Picked By
Lemuel, -
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Question
cskeeter
I'm completely lost and I'm sure this will get a little long....
My husband has a 10% rating for an ankle injury while on active duty. I've been doing ok with the VA up to this point....at least I thought so! I didn't think it would be nearly this hard actually. I'm currently trying to get a higher rating and gerd added to his service connected illnesses but to be honest I think my 6 year old will be eating veggies with no complaints before this is over. My husband is young (31) and had surgery in 2001 on his ankle. He broke all his tendons and ligaments in his ankle and had to have it all reconstructed. The injury could have been avoided (I think anyway) had the Army done the surgery sooner b/c he kept spraining it over and over and then finally in March of 2001 he fell 15 feet out of a tree and broke everything in there but the bone. They finally got him into surgery in Sept of that year. Anyway, in all those months he was taking naproxen/alleve for the pain apparently taking this medication daily like he did can cause constant heartburn/gerd. He's been taking some RX medication for this (the VA doctor he saw wrote it for him) but the VA doesn't want to add the illness because there is no record of it. It actually took us years to figure out it was the meds causing the heartburn. The VA doctor he saw was the first to suggest it. Oh and another issue on this claim is the idiot doctor that did the exam for the claim somehow brought his left ankle into the claim and they are saying that since we are linking it to the left thats another reason nothing is covered along with saying that my husband said he'd had heartburn long before this ankle injury. He never had heartburn like this before his ankle injury.
He has been seeing our ortho surgeon b/c in August I believe it was the surgeon he saw at the VA said surgery won't fix his problem and that he was going to have to live with the pain. The overall care he gets is just horrible. I can't imagine a doctor telling a patient that he has no options and will have to live in pain. I made him an appointment with our doctor and apparently he has a bone spur on the front of his ankle that is causing the pain. We already knew the bone spur was there from an xray this same doctor did in 2005 but at that time it was a small spur that wasn't needing any treatment at the time. He went back recently because the pain is just too much at times and this small spur that the VA led us to believe was there is actually covering the entire front of this bone. Our surgeons opinion in 2005 was that it might need surgery b/c it is possible it will get bigger but there was a chance it wouldn't get any bigger. Well, he now says the only option is surgery.
I know the VA won't cover our out of pocket cost for a surgery as I am fairly certain our insurance won't cover it 100%. My husband has no faith in the VA hospital and its staff at all. What choice am I left with but to figure out how to pay for it on our own? Obviously I wouldn't want someone doing surgery on me if I had no trust and faith in them and I don't expect him to just suck this up and use the VA. Is there some complaint process here?
If we could get a higher rating it would cover the out of pocket expenses we have using our own doctors. At this point the only thing the VA is good for is getting him his pain medication at no cost and the heartburn medication at a reduced price. I'm thankful for the prescription coverage he is getting because that would cost me an arm and a leg. One of the doctors there asked him if he could find a new job to stay off his feet. This injury has limited his activities greatly. I'll also add that the VA also added that his range of motion is fine in his ankle and until it gets worse they won't raise his rating.
Any thoughts, insight, help would be greatly appreciated!
Thank you
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